Monthly Archive for July, 2007

NIH Letter about Products Containing Lavender and Tea Tree Oils

The same day I wrote a recommendation for a soap containing tea tree oil, I heard from a pharmacist about a paper that suggested a possible link between the use of products containing lavender and tea tree oils and gynecomastia (breast enlargement) in young boys. Only 3 cases prompted the study, but the researchers also did in vitro studies demonstrating endocrine disruption activity by both lavender and tea tree oils. And, when the each of the boys ceased using the personal care products with those oils, the gynecomastia resolved. (I should note that the only oil all of the boys used was lavender; only one of the boys used a product containing tea tree oil, and that product also contained lavender.)

http://www.nih.gov/news/pr/jan2007/niehs-31.htm

The NIH letter was careful not to draw any conclusions, it merely alerted the medical profession to the study. Per the study author, there still is much work to be done to draw any conclusions. As always, the issue of exposure strength and duration is a big question mark when it comes to applying this study more broadly. (I would personally want to know if the products were detergent products – probably so, one definitely was – another factor in exposure because of increased membrane permeability.) And there are other endocrine disruptors in most modern environments, such as plasticizers, which were not concurrently studied or considered and could be an additive factor.

The pharmacist who wrote me said her professional opinion would be for parents to avoid products with these oils (lavender and tea tree oil). Children do have more permeable skin than adults.

In the interest of providing as much perspective as possible, I am also including a link to an article by respected naturopath Dr. Randall Neustaedter. It discusses both sides of the issue regarding tea tree oil. [link]

Allergic contact dermatitis to tea tree oil is another potential concern [link 1][link 2], if anything, more well-documented than the above.

All I have to say is that I believe in erring on the side of caution with kids.

Caress Is/Isn't Dove?

As I mentioned in a previous post, Caress appears to have a nearly identical surfactant formula to the old unscented Dove. Now that I’ve tried it, I’m not sure I like it that much. I don’t know if it’s because the added shea butter or Vitamin E (depending on the flavor) makes it feel different and rinse less well, or something else.

I’m also wondering if the parent company is going to keep the surfactant formula in Caress the same, rather than switching it over as they have Dove. I have looked at Caress boxes in various drugstores and discount stores – if they were going to switch over to the new Dove surfactant, they probably would have by now. This is all my speculation, I have no idea what will happen.

In the meantime, I’m bringing all those extra boxes I bought of Caress back to the store. Because of the way Caress rinses, it doesn’t appear to be a good replacement for the old unscented Dove per the solveeczema web site, even though the surfactant formula is almost the same. However, provided the product is labeled properly (and hasn’t also been switched to the new surfactant in Dove for Sensitive Skin), and the additional ingredients don’t otherwise cause individual allergy, the product should be okay for those with detergent-reactive eczema.

I say SHOULD, but I don’t have the kind of empirical information on Caress that I had on unscented Dove. Always test. True soaps are a very narrowly defined surfactant, so I can say that all true soaps are fine. Anything else really requires a lot more information.

More Recommendations

Here’s a real find:
http://www.lcdpmarseille.com/

I tried the Savon de Marseille Extra Pur Orange. It’s a liquid soap with a heavenly fragrance. The ingredients are: Water, Potassium Cocoate, Fragrance, Glycerin, Hydroxyethylcellulose, Cocos Nucifera, Tetrasodium EDTA, BHT, Limonene, Linalool, Citral. It seems to clean well without drying, very nice. The scent doesn’t seem to remain on my hands, but washing with this stuff is a little dose of aromatherapy. There are other similarly wonderful scents, like grapefruit and apple.

The only drawback seems to be the price. Ouch. Imported from France.

A wonderful surprise in the bar soap realm is Tea Tree Therapy Vegetable Base Soap with Tea Tree Oil. Made in USA, distributed by Tea Tree Therapy, Inc., Ventura, CA. This is a great bar soap that gets the skin clean, rinses well, is not drying yet doesn’t leave any sticky feeling as some more moisturizing soaps do. Tea tree oil is supposed to be a natural antiseptic. This soap has a fragrance, but it’s so mild, I initially thought it was unscented. I hope they keep it that way!

Ingredients of Tea Tree Therapy Vegetable Base Soap: Vegetable Base (Sodium Palmate and Sodium Cocoate), Purified Water, Vegetable Glycerin, Natural Fragrance, Titanium Dioxide, Sodium Chloride, Tea Tree Oil, Iron Oxide, Tetra Sodium Etidronate, Tetra Sodium EDTA.

Note: Please see later entry in this blog about tea tree oil and potential concerns with children.

Detergent and Natural Soap Sales Trends

Interesting links about soap and detergent markets:

About natural soap sales: http://answers.google.com/answers/threadview?id=470727

About detergent sales: http://www.purchasing.com/article/CA6297730.html

As noted on my site, many “natural” washing products are essentially plant-based detergents. But there are many true soap lines out there – profitable for major manufacturers AND smaller handcrafted soap makers – and sales of handcrafted soaps appear to be increasing. I assumed these product lines were miniscule compared to detergent lines; if you factor in “natural” detergents, perhaps they are.

It’s interesting, though, to note the strong consumer demand for natural personal care products. At least by these sources – and admittedly, I just found them with quick Google searches, not by thorough review – the natural personal care industry is a major player and growing fast.

What will detergent makers – and “natural” product makers – do about this over time, I wonder? The problem of eczema and dermatitis seems to be great enough to significantly impact demand for “natural” products; too bad for these consumers that marketing hype seems to be the biggest driver in this industry for now.

However … as major organic food producers learned, they should never underestimate the intelligence and underlying motivations of “natural” product buyers. Natural personal care product standards are under scrutiny. Stay tuned.

ISO unscented Dove?

When unscented Dove changed its surfactant formula earlier this year (see other posts about unscented Dove on this blog), I noticed that several other products within the Dove line still carried something similar to the old formula. No longer. Dove appears to have switched its entire line over to the new primary surfactant, which makes sense from a manufacturing standpoint. Any remnants were probably leftover inventory of other product lines.

If you are looking for products similar to the old unscented Dove formula, Caress Glowing Touch is virtually identical, with a few minor differences like fragrance and dyes. Caress Glowing Touch also has shea butter as a minor ingredient, and propylene glycol, neither of which were in unscented Dove. I suspect the Caress Glowing Touch boxes I recently purchased are old inventory and that Caress, too, might soon switch to a new surfactant formula similar to the new unscented Dove Sensitive Skin.

If you are looking for a stash of bar products similar to the old unscented Dove formula, the clock may be ticking on availability of these products. Johnson Diversey makes Dove and Caress lines, as well as many others. See www.jdbrands.com . Interestingly, they also make Lux, which withdrew its soap flake product line a few years ago.

New vs. Old Unscented Dove

For comparison, here are the formulas of the new unscented Dove Sensitive Skin bar products (not okay per the solveeczema.org site) and the old unscented Dove product (fine per the solveeczema.org site):

Old formula (fine per solveeczema):
Sodium cocoyl isethionate
Stearic acid
Coconut acid
Sodium tallowate
Sodium isethionate
Water
Sodium stearate
Cocamidopropyl betaine
Sodium cocoate or sodium palm kernelate
Sodium chloride
Masking fragrance
Tetrasodium EDTA
Tetrasodium etidronate
BHT
Titanium dioxide

New Dove unscented Sensitive Skin formula (not okay per solveeczema web site):
Sodium lauroyl isethionate
Stearic acid
Sodium tallowate or sodium palmitate
Lauric acid
Sodium isethionate
Water
Sodium stearate
Cocamidopropyl betaine
Sodium cocoate or sodium palm kernelate
Sodium chloride
Tetrasodium EDTA
Tetrasodium etidronate
Maltol
Titanium dioxide

Recommendation for Dove Withdrawn Until Further Notice

Until further notice, I must withdraw my recommendation for Dove bar products. (I have never recommended the liquid products.)

For general use, and especially for “the washing test” on the solveeczema.org web site, I no longer recommend using Dove or any bar products with the same surfactant formula as Dove’s current unscented Sensitive Skin product, the formula of which was changed as of January 2007. See previous posts on this blog for more information.

Initially, there were several products with the same surfactant formula as the OLD unscented Dove formula with sodium cocoyl isethionate (give or take a few fragrances and colors), but they, too, seem to be changing over to the new surfactant formula with sodium lauroyl isethionate.

Here’s the problem:

I can recommend that people use any soap product, because soaps are a very narrowly defined surfactant. Thus, I can say that all soaps, provided they are relatively non-drying (and there are MANY non-drying soaps) should be fine for people with detergent-reactive eczema (also provided there are no individual ingredient allergies).

Without getting into a detailed discussion about Dove, empirically, unscented Dove, a combination of mild detergents, soaps, and fatty acids, was also fine. It was more than fine, actually, it worked especially beautifully to remove existing detergents on the skin that are a problem for people with detergent-reactive eczema.

Unfortunately, I have no such empirical information about the new formula. In fact, the majority of visits to my blog these days appear to be from people trying to figure out what happened to the old unscented Dove formula. I have received several reports of problems, though I cannot draw conclusions until I know much, much more.

The old unscented Dove product had lots and lots of empirical support, not just from those who successfully used my site, but from dermatologists’ experiences over many years. I have no idea why Dove’s maker would want to monkey with this successful product line.

Until further notice, instead of unscented Dove for the “washing test” on the solveeczema.org web site, use Cal Ben’s liquid dish glow from a foaming dispenser. (Do not use it straight as it is quite concentrated.) Rinse especially well. As always, spot test it first to determine personal sensitivity to the ingredients.

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Toothpaste without detergent

Toothpastes are some of the more difficult products to find without detergent. The shelves of the health food stores carry choice after choice of “natural” toothpaste with detergent. Not just any detergent, usually sodium lauryl sulfate, one of the worst if detergents give you eczema.

There are a few, mainly European, choices that don’t have detergents in them, but they do have large amounts of sorbitol, which I don’t personally tolerate well. I’ve run across so many other adults who have the same trouble with sorbitol that I’ll admit I haven’t paid much attention to the non-detergent toothpastes that contain sorbitol. In fact, there are only three brands I know off the top of my head that don’t have sorbitol or detergents: Burt’s Bees, Weleda, and Ipsab Tooth Powder.

Only Burt’s Bees and Weleda had children’s versions – until just recently, when Burt’s Bees discontinued selling toothpaste! My local health food store ordered as much as they could, since it was a best seller for them, but even that stock is long gone. I have a healthy stash now myself, most of which I ordered through Amazon.

Weleda package inserts state that “All WELEDA Toothpastes are free from fluoride, detergents, synthetic fragrances, colors and preservatives. … All WELEDA Toothpastes are developed in cooperation wtih dentists and are scientifically tested.”

It’s too bad about the fluoride, I wish someone would come out with a non-detergent fluoride toothpaste.

Surprising Observations About Dry Skin

Here’s an interesting email I received from a mom last year:

“thanks … since we switched to [soap products] this winter, nobody in my family has had dried, cracked skin (esp. around the knuckles), we’d ALWAYS have this problem, every year, during winter. but not this year, despite some intense soap washing (many kiddie outings, germs, etc.). just wanted to let you know since that was an unexpected benefit. thanks again!”

After following up, I discovered that this mom made the switch to soaps for her household after reading the site for other reasons – no one in the household suffered from eczema.

This is a counterintuitive result, but no longer surprising. I hear this from many people, that switching to soaps and other non-detergent products – even when some of the soaps are somewhat drying – overall results in skin that is less dry and needs less moisturizing.

After making the switch, usually the family member with detergent-reactive eczema will experience clear improvements in overall skin quality and dryness. The surprise has been that others experience unexpected benefits as well.

I have seen this in my own skin, even though I have never had any problems with eczema myself. Initially, when we switched our household to soaps, I thought “soaps” were so drying. I thought dryness was a compromise I was going to have to make to keep my son eczema free.

But in my case it turned out initial problems with dryness from soaps were the result of 1) past history of using detergent products to wash my hands and a long-term effect on my skin that I hadn’t realized, and 2) exclusively using an especially drying soap product.

Once we’d made the switch long enough that my son’s skin had healed and become more substantial, I realized that my own skin was less dry and rarely needed moisturizing. When I began mostly using a non-drying soap to wash my hands, I was even able to tolerate the drying soap I’d used before, without the negative effects I’d experienced before the healing period.

Since trying 30+ bar soaps recently, I have seen from experience that there are many, many neutral and non-drying soap products available. In spite of the bad rap soaps have gotten for being drying, I found fewer “drying” soaps than “moisturizing” ones. Finding a product that made my skin feel clean turned out to be a bigger problem than finding a non-drying one.

This effect on skin from exposure to detergents in the months prior to trying something new likely has profound implications for dermatology research, especially since detergents are so ubiquitous in first-world personal care products today.

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Speculations on eczema and sensitization to allergens

Here’s a really well-done and interesting study: Association between severity of atopic eczema and degree of sensitization to aeroallergens in schoolchildren. (So much great dermatological research coming out of Germany these days.) If you click on the link, a wealth of related research pops up to the right.

Conclusion of the above study: “The degree of sensitization is directly associated with the severity of atopic eczema. We speculate that early epicutaneous sensitization to aeroallergens may be enhanced by damage of the skin barrier function. The specific IgE response seems to contribute to the severity of the disease in a dose-dependent fashion.”

It’s another reason to follow our grandparents’ (and Dr. Brazelton’s) advice to use soaps, not detergents, with babies, as detergents can cause a significant increase in skin membrane permeability (which would degrade the skin barrier function), unnaturally increase antigen penetration, and could cause sensitization per this paper, especially in babies who have such naturally permeable skin.

I am left to wonder if another interpretation of the study could be thus:

Given the association I have observed between atopic eczema and detergent reactions, with the severity of eczema being proportional to detergent strength and exposure; and given that detergents increase skin membrane permeability and antigen penetration; and given that detergents are ubiquitous in modern environments, and that what people have been washing with would affect the state of the skin during such a test (the skin changes over the course of months when detergents are eliminated from the home environment, i.e., removal of the detergents from the skin prior to the testing is unlikely to happen, and even if done, it takes months for the skin to normalize):

then it seems to me that the severity of eczema could indicate level of detergent exposure in the study population, which would also then be directly related to antigen load. Those with the most detergent would have the greatest compromise of the skin barrier, greatest antigen load, and greatest sensitization.

In other words, could the degree of sensitization noted in the study be the result of IMMEDIATE effects caused by detergent reactions, rather than just past sensitization (presumably because of the eczema’s effects on the skin barrier)? Or could it be the result of both past and immediate effects? Both are plausible, but knowing the answer definitively makes a difference in how the eczema and allergies might be prevented.

Additionally, the paper would not have taken into account the prevalence of detergents in modern household dust and the increased penetration of aeroallergens in lung tissue as a result. (In other words, the sensitization may not be through cutaneous exposure alone.)

Much of this and related research supports my theory that the eczema reaction may be a warning mechanism by the immune system, similar to the pain response for the nervous system. (See The Big Picture post earlier in this blog.) If the immune system is unnaturally loaded with antigen, it may benefit from “asking” the conscious brain to avoid allergens.

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